1台北馬偕紀念醫院 泌尿科 ; 2國立陽明大學藥理學研究所
Clinical Factors Predicting Ureteral Stent Failure in Patients with External Ureteral Compression
Kwan Ju Wu, MD 1、Chen Yi Zhong, MD 1、Marcelo Chen, MD, PhD 1、Yu-Hsin Chen, MD 1,2
1 Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan ;
2 Institute of Pharmacology, School of Medicine, National Yang-Ming University
Purpose: Double J (DJ) stenting is usually the treatment of choice for relieving external compression of the ureter. However, in some cases DJ function may become impaired and a percutaneous nephrostomy (PCN) may have to be inserted. Studies have reported different predictive factors for choosing PCN or DJ insertion as the initial treatment. In this study, we analyzed the risk factors of DJ failure in patients with external ureteral compression.
Materials and Methods: From January 2011 to December 2018, 65 DJs were inserted in 50 patients to relieve ureteral external compression. DJ failure was defined as 1. hydronephrosis upgrade, 2. a >150% increase in creatinine level from baseline, 3. PCN insertion due to clinically significant symptoms, and 4. DJ dislodgement or malposition.
Results: In univariate analysis, age≧58 years, moderate to severe hydronephrosis, lower ureter obstruction, and preexisting pyuria were risk factors of DJ failure. In multivariate analysis, moderate to severe hydronephrosis and preexisting pyuria were associated with DJ failure.
Conclusion: This study showed that patients aged ≧58 years, with moderate to severe hydronephrosis, preexisting pyuria, or lower ureter obstruction are more prone to DJ failure.